The NHS is to set up a new system that will give healthcare providers unprecedented power by allowing them to appeal against local decisions if they believe they have been treated unfairly.

The move is designed to ensure more rigorous evidence is used for commissioning decisions made by primary care trusts, following a successful High Court challenge to the introduction of a private firm to run two GP practices in rural Derbyshire. It will enable small social enterprises, groups of GPs, as well as private firms to challenge such decisions.

The proposal was first put forward by the NHS Alliance – which represents many healthcare providers and commissioners - last year, in its report: Making trouble for the NHS?. This report found that a small but significant number felt they were being obstructed at the local level. It proposed a new, fast-moving and non-bureaucratic system that would adjudicate situations of this sort.

The report said that local NHS commissioners might create virtual monopolies and to counter that risk it recommended 'service reviews' for those who could show that they are being obstructed.

The idea also builds on a 2005 Social Market Foundation report by Professor Paul Corrigan, a former health adviser to 10 Downing Street, which called for the public to be able to vote out health service commissioners who made unpopular decisions. The new scheme could pave the way for increased patient power over NHS decisions such as prescribing guidance.

NHS Alliance chairman, Dr Michael Dixon, said: “There are all sorts of groups who want to do something new and innovative to improve local healthcare. The NHS needs that entrepreneurial spirit and in most cases it is encouraged. However, a mechanism for challenging official decisions where people feel obstructed is clearly necessary.

“Like any other, the market in healthcare provision needs a regulatory system to make sure it is working as it should. That should be independent of both local NHS organisations and Whitehall.

“The NHS Alliance looks forward to working closely with the Department of Health in developing this worthwhile idea.”

In an interview with the Financial Times, NHS Chief Executive, David Nicholson, confirmed that an independent competition panel expertise would be set up, but the Department of Health was unable to comment on the appeals process. Rob Finch